D-dimer, P-selectin, and microparticles: Novel markers to predict deep venous thrombosis: A pilot study

John E. Rectenwald, Daniel D. Myers, Angela E. Hawley, Christopher Longo, Peter K. Henke, Kenneth E. Guire, Alvin H. Schmaier, Thomas W. Wakefield

Research output: Contribution to journalArticle

120 Scopus citations

Abstract

Current plasma markers for diagnosis of deep venous thrombosis (DVT) allow for exclusion of the diagnosis, but lack adequate specificity to establish the diagnosis. Thus, a prospective study was performed to determine the sensitivity and specificity of plasma assays for D-dimer, soluble P-selectin (P-selectin), and total microparticles in patients with documented DVT by duplex ultrasound. Three groups of individuals were examined: 30 normals; 22 positive for DVT on duplex ultrasound (Group 2); and 21 symptomatic, but negative on duplex ultrasound for DVT (Group 3). Group I individuals had D-dimer values of 1.53±0.12 mg/l and P-selectin values of 0.34±0.05 ng/mg total protein. Group 2 vs. Group 3 individuals had D-dimer values of 7.57±2.03 vs. 3.19±0.79 mg/l, p=0.02; P-selectin values of 0.98±0.11 vs. 0.55±0.08 ng/mg total protein, p<0.01; and microparticle values of 129±17% vs. 99±12% of control, p=ns. Using a logistic regression model with dichotomous variables, we determined a sensitivity of 73%, specificity of 81%, and accuracy of 77% when combining D-dimer, soluble P-selectin, and total microparticles to differentiate Group 2 from Group 3 patients. Logistic regression using continuous variables yielded similar results (p=0.05). This study demonstrates that plasma markers for DVT can be developed and achieve moderate sensitivity and specificity in diagnosing DVT. However for clinical applicability, the sensitivity/specificity will need to be improved. These studies also suggest the importance of soluble P-selectin in assessing DVT in humans.

Original languageEnglish (US)
Pages (from-to)1312-1317
Number of pages6
JournalThrombosis and Haemostasis
Volume94
Issue number6
DOIs
StatePublished - Dec 2005

Keywords

  • Clinical study
  • D-dimer
  • Deep venous thrombosis
  • Microparticles
  • P-selectin

ASJC Scopus subject areas

  • Hematology

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